Nancy Russo

Nancy Russo is a research psychologist at Arizona State University. She is a self-described feminist and pro-choice activist. She was a member of the APA's Task Force on Abotion and Mental Health which was chaired by Brenda Major. She has held a number of high level positions with the American Psychological Association (APA) in particular with relation to pro-choice and feminist issues. Here work has been funded by the Population Council, Family Planning. She was one of the founding members of Division 34 of the APA dealing with population control issues and abortion.[1]

Notable Statements by Russo

The following statements demonstrate Russo's tendency to dismiss scientific evidence demonstrating a link between abortion and mental health problems in favor of a radical pro-choice ideology.

Nancy Russo was quoted in January 2004 by a science reporter from the Toledo Blade newspaper saying "As far as I'm concerned, whether or not an abortion creates psychological difficulties is not relevant...it means you give proper informed consent and you deal with it". [2]

"To pro-choice advocates, mental health effects are not relevant to the legal context of arguments to restrict access to abortion." Russo told Warren Throckmorton, a columnist for the Washington Times. [3] Regarding the latter quote, it is reported that she actually said "it doesn't matter what the evidence says" but Throckmorton agreed to let her rephrase her comments after providing an advance copy of the article for her review.[4]

Chair of the APA's Division 35, Task Force on Reproductive Issues, Russo made the following respponse to APA member Robert Gallagher who questioned the wisdom of the APA taking "a very clearly political stance by explicitly associating itself with the Pro-Choice Forum."[5]

ROBERT GALLAGHER'S STATEMENT has three problems: disregard of APA's history on abortion issues, naïveté about the role of values in science, and misconstrual of the pro-choice position for research on postabortion emotional responses.

In 1969, APA's Council of Representatives resolved that abortion be considered a "civil right of the pregnant woman." More recently, pro-life misrepresentation of research findings led the council to resolve that APA disseminate scientific information on reproductive issues to policy-makers and the public. Our work is a direct response to that mandate.

Gallagher naïvely assumes findings with implications for women's lives can be "apolitical." Science always reflects the values of scientists--the difference here is that we state our values up front and do not pretend scientific methods make findings value-free.

More importantly, he ignores the fact that our Web site is a response to a pro-life campaign that interprets psychological data in inappropriate and destructive ways. Given that "silence is consent," psychologists have an ethical obligation to counter such misinformation.

Finally, the Phillip Morris analogy is inapt. We have no interest, economic or otherwise, in portraying abortion as a risk-free event. A pro-choice position means that we believe abortion is the woman's choice, that women should be given accurate information and informed consent in making their reproductive choices, and that they be supported in their decisions. The charge that this activity, which is congruent with APA policy and conducted in conformance with scientific standards, "undermines the integrity" of APA is without basis.

NANCY FELIPE RUSSO, PHD

Arizona State University

LINDA J. BECKMAN, PHD

Alliant International University

Los Angeles

From this response it is clear that Russo clearly believes the APA's political position on abortion as a civil right is warrant for pro-choice activism.

Views on Abortion and Informed Consent and Screening

Abortion counseling should be "tailored to the patient's individual situation and needs....Relative risks of abortion versus its alternatives will differ depending on the context. ...Providing informed consent for mental health outcomes of a pregnant woman's options is complex, particularly when a major determinant of how a woman responds to an abortion is how she appraises the meaning of abortion and its alternatives. Abortion can be viewed as a profound threat, a coping tool, or both.

These findings have profound implications for the informed consent process as well as effective prevention and intervention. They point to the importance of providing informed consent in ways that will help women to understand the role their appraisal process plays in shaping their psychological responses to however they choose to resolve their pregnancy.

Informed consent is also complicated by the fact that mental health outcomes can be difficult to define and may not be easily separated from the effects of preexisting conditions. Pregnant women may have a history of mental problems, lack coping skills, and live in unsupportive social environments. As a result, they may be anxious and depressed and at risk for unwanted pregnancy. If such women have histories of physical and sexual abuse or have violent partners, they may even suffer from posttraumatic stress (McGrath, et al., 1990).

Such women are at risk for mental health problems regardless of how they resolve an unwanted pregnancy (see Russo, 1992). If they chose abortion, however, the cognitive distortions and negative emotions associated with their preexisting depression and posttraumatic stress may make them particularly vulnerable to pro-life propaganda designed to convince them that their symptoms were caused by their abortion experience. The fallacious implication is that having an unwanted birth would have alleviated their distress.

Given that women who have unwanted pregnancies are much more likely to have experienced childhood physical and sexual abuse and intimate violence, the pro-life targeting of the appraisal process is particularly disturbing. The myths and misinformation of pro-life propaganda reinforce the historical silencing of women around violence issues, and may distract women from dealing with the effects of preexisting conditions. In particular, women suffering from posttraumatic stress due to experiencing violence can recognize their symptoms and 'see themselves' in postabortion syndrome propaganda.

Women need to understand the importance of their appraisals of abortion and its alternatives in determining their mental health outcomes and be alerted to the fact that they may encounter pro-life propaganda designed to make abortion traumatic by manipulating those appraisals.

...Resolving an unwanted pregnancy involves a profound and personal decision, arguably the most important decision a woman will make in her entire life. The easy path would be to just let 'nature take its course' and 'let come what may'. The responsible path, however, forces a woman to examine her values, responsibilities, and realities, and involves a process that can involve painful self-judgments. Making a thoughtful decision, whatever alternative is chosen, requires the courage to strip illusions from one's self, relationships, and circumstances, the strength to take responsibility for one's irrevocable actions, and for women who are or want to become mothers, the caring to put the well-being of one's current and future children first and foremost in what is a complicated decision-making equation.

...An abortion decision can also be made traumatic even for a mentally healthy woman if the decision is coerced or stigmatized by others (e.g., by a partner, parent, or important authority).

...If women feel troubled after abortion they should seek help from a licensed mental health provider. Their feelings should not be trivialized or dismissed, but need to be examined beyond focusing on the abortion per se or the 'baby that might have been'. A host of issues need to be explored, including negative self-discrepancies in women's visions of themselves as good and worthy persons, intimate partners, mothers, and daughters, among other things (for examples of the complexities underlying negative feelings in response to abortion see Torre-Bueno (1996) or visit http://www.peaceafterabortion.com).

Informed consent requires that a women and her abortion provider (physician and/or pregnancy counselor working with the physician) discuss a woman's situation calmly and thoughtfully until she is ready to make what must be her own decision - a decision that she must come to terms with and put to rest. The bottom line is that there are no absolute risks for legal abortion that apply to all women. For any individual woman, both the absolute and relative risks of the negative physical and mental heath outcomes of abortion and its alternatives will be unique to her personal history and situation. Given the intense campaign to manipulate the appraisal process, her risk will depend on her future exposure to pro-life propaganda as well.

Her study Violence in the Lives of Women Having Abortions: Implications for Public Policy and Practice.[7] finds higher rates of depression associated with abortion. But she is able to make the suppress the significance of this association by controlling for exposure to violence. This is wrongly done, however, because she controls for both exposure to violence before and after the abortion. Since abortion may increases the risk of subsequent exposure to violence, it is inappropriate to control for a confounding effect that occurs after the abortion. Another problem is that the level of violence was not controlled for nor the duration or number of exposures to violence. For example, "refusing condom use" was included as one of the forms of violence. Any violence Still another major deficiency of the study is that it included only couples who were married or living together. Women who were not cohabitating at the time of the interview were excluded.

In 'Abortion and mental health' Fergusson, DM. The Psychiatrist (2008) 32: 321-324. (editorial), Fergusson does not buy into Russo's claims that her NLSY study refutes the finding of Reardon in Cougle. He describes that her study "purported to show that, when a different sample selection method was employed, there was no significant association between abortion and depression (full sample OR=1.33, 95% CI 0.84-2.10)" (emphasis added). He also noted that Russo and other commentators failed to note that "the NLSY data contained three major flaws that prevented clear conclusions from being drawn." Reardon and Cougle, by contrast, had discussed this limitation.

Commentary On Russo Comments and Causal Connections

Nancy Russo is not an unbiased reviewer. She is a radical pro-abortion feminist who in 2004 told a Toledo Blade science reporter, Jenni Laidman, that "whether or not an abortion creates psychological difficulties is not relevant." Her own research was dismissed by the same APA panel she served on for more severe methodological flaws than the studies she dismisses.

She is on the forefront of the abortion-defense squad, doing everything she can to turn attention away from scores of well designed studies showing abortion is consistently statistically associated with negative emotional reactions, including substance abuse, elevated suicide rates, depression, anxiety, and more.

She is serving exactly the same role as experts defending the cigarette industry did when they continued to raise the standards of proof required to prove causal connections between smoking to lung disease. Statistical associations, they rightly asserted, do not PROVE causal connection. It's just possible there may be some other explanation for the statistical association. For example, smokers may just be more likely to be painters who inhale toxic fumes from paint.

The same strategy is being applied to the abortion debate. Deniers of mental health problems associated with abortion, led by Russo, cannot deny the fact that there are literally scores of studies showing significant statistical associations between abortion and mental health problems. So the only option left to them is to harp about the imperfections of the studies and focus on their last line of defense, the lack of definitive causal proof for each and every negative reaction that has been shown to be statistically linked to abortion.

That line of defense is impregnable because it is simply impossible to prove a causal connection between any voluntary act and subsequent mental health. You simply can't do a randomized, double blind study with abortion (assigning a random sample of women to be impregnated and a random subset aborted and the others required to carry to term).

As a result of this limitation, the simple fact is that every study has methodological weaknesses. Even the national record based studies in Finland showing that in the year following a pregnancy women who abort are six times more likely to commit suicide compared to women who give birth, can be dismissed as failing to prove that abortion, in and of itself was the sole cause of any of these suicides. Indeed, it is likely that abortion was not the sole cause of any of the suicides. On the other hand it is likely that it was a contributing cause to very many of these suicides.

Another fact that Russo ignores is that the issue of causal connections can be addressed not through statistical tests so much as by listening to women.

In the controversy about whether smoking causes lung disease, the assertion that a patient "knew" his cancer was caused by smoking (as opposed to painting) is not convincing because we can't self observe how our lungs are reacting to smoke and paint fumes.

But with regard to psychological distress, it is a different matter. People are self-aware. We can and do observe how our minds are reacting to our experiences and past decisions. We may not observe ourselves perfectly, and we may at times deceive ourselves. But it is certainly anti-scientific and opposed to all of the principles of psychology to universally dismiss the self-assessment of the millions of women who have had abortions who say their grief over a past abortion is the cause of their ongoing psychological distress.

The fact is that many women report something along the lines of: "I think about the abortion all the time. It makes me so depressed I think about suicide. I've tried to bury these feelings with alcohol."

In addition, the studies dismissed by Russo prove that such reports are not rare or isolated and, moreover, that these negative reactions are statistically associated with abortion in large samples of women.

Russo is essentially saying, "Ignore the smoke. Abortion can't cause fires because we know it is a basic human right of women to have an abortion if they choose. And if a few women complain, they are just whiners who have been guilt-tripped into becoming the foils for the opponents of abortion rights."

I just don't buy it. I believe the women who say their abortions caused mental anguish. And I believe the dozens of studies linking abortion to mental health problems are measuring real smoke caused by a real fire.

Russo, N. F. & *Dabul, A. J. (1997). The Relationship of Abortion to Well-Being: Do Race and Religion Make a Difference? Professional Psychology: Research and Practice, 28, 23-31. Excerpted in Family Planning

Russo, N. F. & *Denious, J. E. (2001). Violence in the Lives of Women Having Abortions: Implications for Public Policy and Practice. Professional Psychology: Research and Practice, 32, 142-150.